Body mass index and the risk of suicidal ideation and suicide attempt among youth in 45 low-and middle-income countries

Abstract

BackgroundSuicide has become a severe public health issue worldwide. Body weight has been put forward as a potentially modifiable element for suicide thought and behavior. However, there are discrepancies across previous studies. Furthermore, the relationships of body weight with suicidal ideation and suicide attempt among low- and middle-income countries (LMICs) remain unclear. Therefore, we addressed this issue among 104,907 adolescents of 12–15 years old in 45 LMICs. MethodsThe present study used data from the Global School-based Student Health Survey (GSHS). Suicidal ideation and suicide attempt during the last year were self-reported. Participants were classified intro underweight, normal weight, overweight and obesity according to their body mass index classification. Multivariable logistic regression and meta-analyses based on country-wise estimates were conducted. ResultsThe prevalence of suicidal ideation and suicide attempt were 11.8% and 13.0%, respectively. Countrywide meta-analysis demonstrated that overweight and obesity were significantly associated with increased risks of suicidal ideation (For overweight: OR = 1.10; 95% CI = 1.01–1.20; for obesity: OR=1.17; 95%CI: 1.01–1.35) and suicide attempt (For overweight: OR = 1.12; 95% CI = 1.02–1.23; for obesity: OR=1.12; 95%CI: 1.00–1.25). Subgroup analyses showed that the associations between overweight/obesity and suicide attempt were significant for girls but not for boys. LimitationsThe cross-sectional design cannot explore causality; mental health factors were not assessed; suicidal behaviors were self-reported; significant heterogeneity across countries; only students attending school were included. ConclusionsOverweight/obesity was significantly associated with the risk of suicidal ideation and suicide attempt among adolescents in LMICs.